The Appropriateness of Post-Exposure Management in Patients at Risk to Rabies in Emergency Room, Srinagarind Hospital

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Thapanawong Mitsungnern
Thawatchai Saetia
Dhanu Gaysornsiri

Abstract

Background and Objective: Rabies is zoonosis with high mortality rates. The post-exposure management of patients at risk impact to spreading in human. So we aimed to study the percentage of appropriateness in post-exposure management of patients at risk to rabies by using 2013 Rabies practice guideline of Department of Disease Control, Ministry of Public Health, Thailand.


Material and Methods: A retrospective descriptive study enrolled patients who visited Srinagarind hospital between January to December 2014 by using International Classification of Diseases and Related Health Problem 10th revision (ICD-10) code T14.1, W50-W55, Z24.2.  


Results: After searching by ICD-10 codes, 2009 patients were enrolled and only 960 cases met our criteria. Five hundred thirty six cases (55.8%) were women. The average age was 35.8 years old and average duration from exposure to medical contact was 13.4 hours. The most common carriers were dog (66.0%) and the characteristics of exposure were biting at leg or hand and 461 wounds (48.0%) were level III that classified by World Health Organization (WHO) category. But there were only 806 cases that contained enough data in medical record to decide appropriateness in post-exposure management. Finally, we found the overall appropriate management was 48.3%, appropriate rabies vaccine was 95.2%, and appropriate rabies immunoglobulin was 91.1%.   


Conclusion: The post-exposure management of patients at risk to rabies by 2013 Rabies practice guideline was proper at 48.3%. Emergency physicians need to update the post-exposure management of patient at risk to rabies and complete the important data in medical record for patient safety.   

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References

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